Introduction Diabetic foot ulcers (DFUs) are often erroneously thought to be a minor complication of diabetes. Diabetic foot ulcers usually start as an innocuous blister from rubbing on a shoe that is too tight, or at the site of an…
Introduction Diabetes and its subsequent complications, including diabetic foot disease, is a rapidly growing global health pandemic and a major financial burden on healthcare systems worldwide. The International Diabetes Federation estimated that over 463 million people suffer from diabetes in…
Limb amputation, practiced throughout the centuries, is one of the most effective surgical procedures. With benefits ranging from pain relief to preservation of life, amputation offers a clear path to cure the patient. Despite the importance of a well-executed amputation,…
Introduction Major lower extremity amputations continue to be part of all vascular practices despite the general approach of aggressive limb salvage. Although often viewed as a failure of treatment, a major amputation should be considered a reconstructive and definitive treatment…
Introduction The use of endovascular therapies for the treatment of infrainguinal vascular disease has become a key component of a multimodal approach to manage peripheral arterial disease. The decision to employ an endovascular-first interventional strategy relies on several factors, including…
Acknowledgment The illustrations were drawn by Joseph L. Mills, Jr. Lower extremity arterial reconstruction is most commonly performed in patients with moderate to severe limb ischemia due to atherosclerotic peripheral artery disease (PAD). Although the techniques described below may also…
Background Progress in endovascular surgery has resulted in a continued shift in the treatment of patients with aortoiliac occlusive disease to less invasive forms of therapy. Early pioneers such as Dotter and Gruntzig developed balloon angioplasty. Subsequent work in stent…
Direct replacement or bypass procedures for aortoiliac or infrainguinal arterial disease were developed in the 1950s. The procedures discussed in this chapter were generally developed shortly after that as alternatives to more direct procedures. These alternative so-called “extra-anatomic” bypass procedures…
Atherosclerotic disease of the abdominal aorta and iliac arteries is one of the most common therapeutic challenges encountered by vascular surgeons. The British anatomist and surgeon John Hunter first appreciated the implications of aortic bifurcation occlusive disease in the late…
Lower extremity peripheral artery disease (PAD) encompasses a diverse and complex set of pathologies with multiple treatment options. As a result, shared decision making between the patient, their family/caregiver, and the provider is critical. Even the definition of PAD has…